MEDICARE: DR. MICHAEL GRAHAM LENTZ D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	651	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447282363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL GRAHAM LENTZ D.C.

Provider Business Mailing Address
First Line	:	308 2ND ST NE
Second Line	:
City	:	VALLEY CITY
State	:	ND
Zip	:	58072-3019
Country	:	US
Telephone Number	:	701-845-0840
Fax Number	:	701-845-0840

Provider Business Practice Location Address
First Line	:	308 2ND ST NE
Second Line	:
City	:	VALLEY CITY
State	:	ND
Zip	:	58072-3019
Country	:	US
Telephone Number	:	701-845-0840
Fax Number	:	701-845-0840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	07/09/2007

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